Investigations:

 ·       Se. Bilirubin (<2 usually)

·       Alkaline PO4 ase (moderately elevated)

·       SGOT/SGPT (rarely exceeds 100-200u)

·       CPK (markedly elevated )

·       Urine micro (preoteinuria, hematuria)

·       Se. Creat. (can go upto 8mg/dl)

·       Platelets decreased in DIC state.

·       ECG showing changes consistent with myocarditis (ST-T changes)

Establish Diagnosis:

·       MAT- Microscopic agglutination test, useful for serological grouping.

·       Dipstick ELISA- more sensitive than MAT.

Treatment:

·       Severely ill patients…..Penicillin G 1.5 ML. IU/Q6 Hrly or Ampicillin or Erythromycin

·       Less severe illness….. Doxy 100mg/BD OR Ampi 500-750mg Q6 Hrly for 5-7 days

·       Supportive Therapy for Hepatic/ renal impairments

·       Treat Hypotension/ Major Haemorrhage